Provider Demographics
NPI:1578369559
Name:EPREM, GRACE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:EPREM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 LAS VIRGENES RD STE 203
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1993
Mailing Address - Country:US
Mailing Address - Phone:818-271-0693
Mailing Address - Fax:
Practice Address - Street 1:4505 LAS VIRGENES RD STE 203
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1993
Practice Address - Country:US
Practice Address - Phone:818-271-0693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93092355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant